Abstract: SA-PO284
The Study on Value of Bone Scan Technology in Early Diagnosis of Calciphylaxis
Session Information
- Bone and Mineral Metabolism: Calcium, Magnesium, Kidney Stones
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Liu, Yuqiu, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
- Yang, Xin, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
- Yang, Canlin, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
- Xie, Xiaotong, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
- Liu, Bi-Cheng, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
- Zhang, Xiaoliang, Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China
Background
Current diagnostic criteria for calciphylaxis are based on ischemic necrosis and ulceration of skin and soft tissue. Nevertheless, once clinical diagnosis is confirmed, the disease progresses to the end stage with terrible prognosis. This study is aimed to investigate the early diagnostic role of bone scan technology in calciphylaxis patients undergoing dialysis, considering that this technology can reflect abnormal distribution of hydroxyapatite in eatra-osseous tissue.
Methods
Analyzed clinical data of 15 hemodialysis patients with calciphylaxis diagnosed by skin biopsy who had bone scan results in Zhongda Hospital Southeast University from Oct. 2017 to Dec. 2018. Meanwhile, non-calciphylaxis patients with the similar baseline values of clinical data were screened out (Ratio=1:2). Chi-square test was used to analyze the difference in positive rates of bone scan between two groups.
Results
General clinical data, including age, gender, dialysis time, history of diabetes and secondary hyperparathyroidism (SHPT), had no significant difference between two groups (P>0.05). In case group, 11 patients had positive result of bone scans and the positive rate was 73.3%. The positive results in calciphylaxis patients were mainly the increase in uptake or delay of clearance of radiotracer by soft tissue and the radiotracer under skin was linear or diffuse distributed. In control group, only 5 cases were positive with the rate being 16.7%, whereas the radiotracer was distributed in large patches, which was finally confirmed as SHPT-related metastatic calcification. The difference in the positive rate between two groups was significant (P<0.05). The sensitivity of bone scan for calciphylaxis was 73.3%, with the specificity being 83.3% and the Yoden index being 0.57, indicating bone scan had significant value in diagnosis of calciphylaxis. Moreover, its positive predictive value was 0.69, with the negative predictive value 0.86, suggesting that bone scan technology can be used in clinical work to screen high-risk patients in order to get clue for further examination such as skin biopsy to make early diagnosis of calciphylaxis.
Conclusion
Since bone scan has a high sensitivity and specificity in the diagnosis of calciphylaxis with a wide range of uptake for radiotracers by soft tissue, it has important application value in early diagnosis of calciphylaxis.